How cervical curvature changes after ACAF and ACDF: a radiological retrospective study

Area of Science:

• Spine surgery
• Orthopedics
• Neurosurgery
• Biomechanical engineering

Background:

• Cervical lordosis is crucial for spinal health and function.
• Degenerative cervical spine conditions often require surgical intervention.
• Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical approach.

Purpose of the Study:

• To evaluate changes in cervical curvature after Anterior Cervical Arthrodesis Fusion (ACAF) and Anterior Cervical Discectomy and Fusion (ACDF) surgeries.
• To demonstrate the feasibility of ACAF technology in restoring cervical lordosis.
• To compare the effectiveness of ACAF versus ACDF in spinal canal expansion and curvature restoration.

Main Methods:

• Retrospective analysis of imaging data from 47 patients undergoing multilevel ACAF or ACDF.
• Measurement of total cervical curvature, anterior, middle, and posterior column curvature, spinal canal diameter, and cervical range of motion.
• Non-parametric and chi-square tests for pre- and post-operative data analysis; Spearman correlation for imaging data relationships.

Main Results:

• ACAF surgery resulted in significantly greater postoperative changes in cervical lordosis angle and vertebral canal diameter compared to ACDF (p = 0.015).
• ACAF demonstrated larger median and change values in middle column curvature and smaller change values in posterior column curvature (P < 0.05).
• Expansion of vertebral canal diameter correlated with middle and posterior column curvature differences (r = 0.523, P < 0.01).

Conclusions:

• ACAF is a feasible technique for restoring cervical lordosis and significantly expands spinal canal diameter.
• ACAF achieves greater spinal canal expansion by increasing middle column curvature and reducing posterior column anterior movement compared to ACDF.
• Curvature changes in the anterior, middle, and posterior cervical columns are interrelated and influence spinal canal dimensions.